Melatonin for Kids: Hit the Snooze or Not?

I don’t think I’ve had a good night’s sleep since the Bush administration (second one).  I’ve always been a light sleeper. When I was a teenager my mother used to joke that all she had to do was stand quietly in my bedroom doorway and I’d wake up.  Sadly, this has become absolute reality for me and I know many adults who are in the same boat.  Most kids, however, when they get beyond the first couple of years, are pretty good sleepers.  Except the few who aren’t.

Sleep medicine as a whole is a rigorous scientific field these days, but right now I want to focus on a specific question that was asked of me recently:

Can I give melatonin to my child who has difficulty sleeping?

The answer is: Yes, you can.

But like everything, it’s never THAT easy, is it?  So let’s do a quick Q & A:

What is melatonin?

It’s a hormone produced in the pineal gland in the brain.  Yes, when you take supplemental melatonin you’re taking a synthetic hormone.

What does it do?

Melatonin helps regulate the circadian rhythm in the brain that helps control the sleep/wake cycle as well as many other cyclic body functions.  It’s typically released by the body in the evening, triggered by darkness.  There’s not much of it around during the light of day.

Does taking melatonin help a child sleep?

The data that exists in children supports the claim that melatonin helps a child FALL asleep (in other words, shortens the time it takes for a child to fall asleep).  That being said, it’s NOT that clear that melatonin helps a child STAY asleep. So it’s difficult to predict for certain if melatonin will be helpful on the whole to any individual child.  It’s generally taken about 30 minutes before sleep, and sometimes it’s used to help shift a child’s sleep schedule a few hours earlier.

Is it safe?

Research suggests that low dose melatonin, not taken long term, is indeed safe with few potential side effects (bedwetting, dizziness, nausea and headaches).  It is not an addictive substance.  What we DON’T know is the long term effect of taking this supplement—not just on sleep but on other body functions, like puberty and development.  It’s important to know that melatonin preparations are NOT regulated by the FDA or any other regulatory agency, so it’s important to read the label VERY closely. Equally as important is to speak with your child’s pediatrician about starting this supplement so that you can partner together on the game plan for dosing and duration.

What else should you do?

Melatonin should NOT be used on its own.  In fact, most important to your child getting a good night’s sleep is good sleep hygiene.  Melatonin is not going to do the trick if you aren’t already helping your child get to sleep with good behavioral practices, like avoiding stimulating TV or electronic devices for the hour before bedtime, having a quiet, dark, cool bedroom, and a very CONSISTENT bedtime and bedtime routine free of late afternoon naps.

So who should consider melatonin?

-Kids who have unexplained insomnia (not due to stress or other medical reason)
-Kids for whom a good, long trial of consistent behavioral sleep hygiene routines have not worked.
-Kids and parents who will partner with their pediatrician to manage the dosing and regimen.

I’ve considered taking melatonin myself, but given the reading and reflection I’ve done for this blog entry, I realize I’ve got a fair amount of cleanup to do on MY OWN personal sleep routine (ummm… turning off bedtime electronics!) before I entertain the idea.  No nap for me today.

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